How we take care of our mental health

I like to joke that startup founders eventually become interested in mental health because startups turn you into a nutcase. I got interested in this topic about six years ago during some of the toughest times of my startup journey, and I feel much stronger today mentally having worked on it. I wanted to go beyond my own experiences to talk to other “users” of mental health and write about it as part of a regular series where I explore various topics that interest me (check out my last article about my teenage nephews’ digital habits), so I posted this to Facebook.

People love an excuse to talk about their mental health

Based on the number of comments, my post definitely struck some kind of nerve. Over the past two weeks, I was able to talk to twelve of my friends about their experiences with mental health. Note that my friends are mostly in their late-twenties / early-thirties and relatively privileged in society, and I’m not a mental health professional but simply viewing their experiences from the perspective of a startup founder interested in building something useful in the space.

As the conversations got going, I quickly realized what I got myself into. I assumed people wanted to tell me about solutions like how they meditate and what kind of therapy they go to. Instead, almost everyone I spoke with wanted to give me a bigger picture of the journey they had to go through to get better. I really had to scramble to grasp the complexity of this problem enough to write about it.

How we become aware of our mental health challenges

The first question I asked my friends was how they became aware of their mental health problems enough to want to work on it. I wanted to find someone who was good at it so it doesn’t seem like it’s always too late and requires a lot of suffering before you realize you can help it. Unfortunately, everyone sucks at this.

For many of my friends, there’s typically a life trigger like the death of a loved one, a health scare or a career failure that hijacks their attention to really tune in to their feelings, but I also think some people are just naturally more in touch with feelings. The stereotype that women are better at this seems true to me. Talking to men about their mental health definitely felt like pulling teeth. A male friend described it as a “lag” — men are aware of their feelings, but they don’t address it until the condition is right (who knows when). Until then, you drown yourself in some other activity that helps get your mind off of it.

I have a friend who was very aware of his emotions starting when he was a small child, but was very inhibited because his immigrant parents called him “too sensitive.” Another friend of mine felt depressed growing up but didn’t really understand it. Her immigrant parents told her, “you don’t get to be unhappy, you have everything.” These children grew up depressed without anyone there to supply the labels and validate their feelings. In some ways it feels worse than simply being unaware because you have to repress the feelings and mistakenly think that something is wrong with you.

Imagine trying to address a problem that you don’t even know the name of. All you know is that you are experiencing pain, so you look for ways to soothe the pain. People come up with all kinds of solutions that aren’t real progress. In my friend group of ambitious young people, the answer is typically to overachieve. It never feels quite satisfying, but it’s the only societal prescription they know. Some people turn to substance abuse and alcoholism.

Sometimes, people get lucky. Maybe someone points them in the direction of counseling. Maybe they came across a book, a lecture, or a website that gave them the words to understand why they feel sad. Maybe the suffering is so great that a switch eventually flips in their brain to start actively defending against it. They go from being a passive victim to an active caretaker of themselves. They know the problem has to do with what’s in their head. As someone who has built startups and interviewed countless users, I’m very unsatisfied with how random this whole process seems to be.

We suck at this as a society. A friend quipped that there’s not a common understanding of what is good mental health versus bad mental health. How do you improve what you don’t know how to measure? As complex as our body is, we still have measurements like our weight, BMI, blood pressure that most people understand despite being imperfect proxies. When it comes to our mental health, we have basically nothing before the clinical definition of mental disorders, which is scary and not user-friendly. “Am I bad enough that I need therapy?” “If I call the suicide crisis line, does that make me suicidal?” “Am I just sad or do I suffer from depression?”

A lot of the commonly touted “solutions” are fraught with friction as well because different things work for different people. Multiple friends told me that “meditation didn’t work for me.” One friend said he basically tries to get into meditation every year and every year he fails. For friends that have sought out therapy, it took most of them multiple tries until they found the right therapist. It’s a miracle how anyone actually gets better.

What it feels like when you are suffering

I feel like it’s important to talk a little about what suffering feels like in the context of mental health. A common feeling is that there’s no one to talk to. Even if you have lots of friends, you feel like your friends don’t understand. Some people don’t have close enough friendships that are conducive to opening up and others simply don’t want to be a burden. This feeling can persist even if you go to therapy because therapists don’t have super powers. You may not connect with your therapist. You may find that they don’t have the context to really empathize with what you are dealing with. Some therapists don’t listen well and sometimes they say the wrong things.

When you try to help yourself and you fail over and over, you start to feel helpless. Learned helplessness can set in and you may retreat from people completely. You can get in a “funk” that lasts many months where you aren’t able to do anything. Getting out of bed becomes difficult. You become numb.

Almost everyone I talk to understands the idea of the downward spiral. When you feel depressed, everything reinforces the depression and it easily spirals out of control. You start to consider suicide or you see that you are only a few spirals away from doing it, but you can’t seem to get out. The downward spiral starts to surface in your relationships. When you are suffering, you attract negative people who make you spiral faster because you forget what normal, positive people look like (or you’ve never known). You don’t let yourself be better. You think you don’t deserve any better.

Getting better is ultimately about a perspective shift

Before going into specific methods people use to improve their mental health, it seems to me that the goal is always some sort of perspective shift. Unfortunately, there’s no easy answer on how people get there. One friend described it as knowing the inputs (your mental problems) and the output (perspective shift), but he has no idea how the function works.

In almost every conversation, I was reminded of how powerful the stories we tell ourselves are. However, I was also impressed by my friends’ abilities to eventually reinterpret the stories or make them less powerful. One friend felt that she grew up disadvantaged and that story led her to feel maligned by parents and an unfair society. Growing up for her was about doggedly fighting that disadvantage and never winning. Today, that story of disadvantage is still there and a source of strength, but it’s only a piece of her much greater story. She no longer feels it viscerally.

One friend felt like he was abandoned by his parents. “Why won’t they love me?” was the question that caused him a lot of grief. Today, he has learned to sit with that feeling of abandonment. One big thing he did was to live abroad by himself. He lets himself be sad when he feels alone instead of feeling bad about being sad, and after a while, his story began to lose its grip. One day he was told that his battles growing up made him who he is today, and he relishes in that new understanding.

A friend defined his life by being an overachiever, but today he focuses on the journey rather than the outcome. Another friend felt like she couldn’t fit in with the overachieving peers she met in college, but these days she has embraced her individuality and loves that she is pursuing a path that is unique to her.

All of these perspective shifts “make sense,” but they happen slowly over time. I asked a friend what would happen if he were to go back and tell his 24-year-old self exactly what he needed to do. He said the message would’ve simply fallen on deaf ears. Even if these new stories make perfect sense, you have to hear them over and over again until the time is right for the message to be received.

I tried to explain to myself why some people seem naturally happier than others. What I came up with is perhaps these people adopted positive versions of stories earlier in their life and they’ve experienced the positive version of the spiral. For example, I have a friend who has always cared mostly about family. I have another friend that loves his freedom above all else, and another who wants to live out his individualism to the fullest. They seem very confident in what they care about, which helps them focus on doing the things that make them happy.

What to do to get better

The “work” people do to get better really varies. Our mind is so complex, different things work for different people. Something that has worked for someone in the past may not work for that same person in the future.

A good place to start seems to be journaling. That’s what I’ve personally found the most useful. Journaling forces me to put the thoughts swirling around in my head down on (digital) paper, helping me sort out what I’m feeling, why I may be feeling it, and creating a healthy distance between me and my thoughts. My friends recommend different variations like Minimalist Journals, Gratitude Journals and Morning Pages, which can help achieve similar effects depending on what you’re looking for. I recently started tracking my mood throughout the day using Daylio, which has enabled to become aware of changes in mood throughout the day and better hone in the causes. I think there’s a lot more that can be done here to popularize tracking mental fitness just like how we track physical fitness.

Daylio (left) helps track your mood through out the day and Youper (middle/right) has incorporated some concepts from the emotional color wheel to help people better label their feelings.

Therapy is very common, but finding the right therapist is so hard a friend described it to be similar to dating. Some go for the same reason why I journal, which is to talk out their feelings and understand them. For me, I was looking to talk to a therapist who has a different background and context than my friend circle, while others look for therapists who have coached successful startup CEOs or dealt with a specific life trauma so they can have the shared context. Some people really care about their therapists’ credentials because that helps them suspend disbelief and buy into a self-improvement program that they otherwise wouldn’t have considered. Others appreciate the therapists age and experience level so that they can feel like they’re not the only ones with the problem. Some friends specifically look to get mental frameworks and thinking exercises from their therapists while others use their therapists just for prescribing anti-depressants. A friend uses a therapist to keep himself accountable to a third party, kind of like a personal trainer. Three people I spoke to go to couple’s counseling, and they use their therapists to help articulate hard truths and moderate uncomfortable conversations. Sometimes the reason why a therapist works out is simply because there’s a connection that helps you feel open to be more vulnerable. This is a really hard matching problem.

This kid is really good at meditation

Meditation has become so popular recently I was surprised to learn that the leading app Headspace only celebrated 1M subscribers in June 2018. That’s such a small number! Most of my friends have tried meditating, but it’s hard for the habit to stick. The most successful friends take their practices very seriously, and one friend mentioned having been on weeklong silent retreats. A friend of mine meditates because he knows his default state is hot-headed, so he meditates twice a day to bring himself down. Another friend meditates so she can practice being okay with all of her thoughts, insecure as they are. A good number of friends like to practice yoga, which is a more physical manifestation of meditation that works for them.

Some of the most transformative effects can be attributed to mentalframeworks people get from therapy, meditation or just reading. For example, “Unlearning ideas that don’t serve you anymore” is a popular framework that, when heard at the right moment in life, can help people get rid of the autonomous programming they grew up with. Another one is “Thought, emotion, and behavior,” which is the idea that whenever one of the elements like emotion gets out of control, you can mobilize the other two elements to bring the emotion back in control. A framework I like for measuring if you have achieved healthy mental state is, “your pain one day will just play like a movie” because that’s when you know you are no longer reacting viscerally to your past traumas.

People who get better practicebeing kind to themselves. It sounds simple but most people prefer to beat themselves up all the time instead. This starts with knowing what activities make you happy, and then proactively seek to do them with regularity. That could mean sleeping in, reading, playing basketball, sending updates to the family group chat, hiking, planning trips, visiting family, volunteering, working out, hanging out with friends, or simply being a potato. Whatever it is that makes you feel good, let yourself do it. Even the busiest people like my friends who are doctors and lawyers find ways to squeeze in an extra 15 minutes of sleep or an extra 30 minutes of alone time in the morning. It’s important to know that what it takes to be kind to yourself can be something really tiny. For example, a friend of mine said that if she has a bad day and she’s about to go to bed, she’ll drink a glass of water to be healthy and call that a win for the day.

You have to be a little lucky or just wait until you’re older

I couldn’t help but notice the role luck plays in all of this. Two people with equally traumatic upbringings can have such radically different interpretations that one person got really good at choosing to be happy and the other person had to struggle for much longer before becoming nicer to herself. Some people were exposed to meditation and mental health because of their parents or religion, while others grew up in families where that’s simply not a thing. This is especially true if their family is immigrant or low-income. Some people have personalities that afforded them close friendships while others had to learn to build relationships that truly served them. Some people had big life events that triggered deep self-reflection while others had to wait until the pent-up feelings finally tip them over in a long and painful process. Some people are lucky enough to reach their goals, even if they’re unsatisfying, false goals, while others don’t even get to achieve the false goals that they thought would give them meaning.

And then there’s just age. They say “time heals all wounds” but also you just give less of a f*ck about your wounds. Time wears out the power of your negative narratives. Some of the friends I talk to swear by their practice or therapist as the reason why they are better, but others hesitate to really attribute their improvement to anything other than just getting older and getting a better understanding of what actually matters. The ego becomes less of a thing as you get older and you begin to treasure relationships, health, family, and yourself much, much more.

To better appreciate the role luck and age plays, I recommend checking out the Oscar-nominated documentary Minding The Gap.

Thanks for reading! Are you working on your mental health? Please leave me your feedback in the comments section.

This is the second post in the series where I deep-dive into topics that I’m interested in by talking to users. Check out the first essay on teenagers and their digital habits: